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Interleukin-8 for diagnosis of neonatal sepsis: a meta-analysis.

Zhou M, Cheng S, Yu J, Lu Q - PLoS ONE (2015)

Bottom Line: The diagnostic threshold analysis showed that there was no threshold effect.The meta-regression analysis showed the cut-off, QUADAS and onset time have no effect on the heterogeneity.However, we should combine the results with clinical symptoms and signs, laboratory and microbial results.

View Article: PubMed Central - PubMed

Affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

ABSTRACT

Background: Neonatal sepsis (NS) is a life-threatening disorder and an important cause of morbidity and mortality in neonates. Previous studies showed that interleukin 8 (IL-8) may effectively and rapidly diagnose NS.

Objective: We conducted the systematic review and meta-analysis to investigate the diagnostic value of the IL-8 in NS.

Methods: The literature was searched in PUBMED, EMBASE, Cochrane Library, CNKI, VIP and other Chinese Medical Databases during October 1998 to January 2014 using set search criteria. Each included study was evaluated by quality assessment of diagnostic accuracy studies tool. Two investigators independently extracted the data and study characteristics, and disagreements, if any, were resolved by consensus. Meta-disc software was used to calculate the pooled sensitivity, specificity and summary diagnostic odds ratio (SDOR), I² or Cochrane Q to test heterogeneity, and meta-regression to investigate the source of heterogeneity. Funnel plots were used to test the potential presence of publication bias. False-positive report probability (FPRP) was calculated to confirm the significance of the results.

Results: Eight studies (548 neonates) were included in this meta-analysis. The pooled sensitivity and specificity of IL-8 were 0.78 and 0.84, respectively, which had moderate accuracy in the diagnosis of NS. The pooled diagnostic odds ratio (DOR) and area under curve (AUC) was 21.64 and 0.8908 (Q*=0.8215), respectively. The diagnostic threshold analysis showed that there was no threshold effect. The meta-regression analysis showed the cut-off, QUADAS and onset time have no effect on the heterogeneity. The funnel plots showed the existence of publication bias.

Conclusion: Meta-analysis showed IL-8 had a moderate accuracy (AUC=0.8908) for the diagnosis of NS. IL-8 is a helpful biomarker for early diagnosis of NS. However, we should combine the results with clinical symptoms and signs, laboratory and microbial results.

No MeSH data available.


Related in: MedlinePlus

The positive LR and negative LR of IL-8 test on diagnosis NS.
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pone.0127170.g006: The positive LR and negative LR of IL-8 test on diagnosis NS.

Mentions: The pooled Diagnostic Odds Ratio of IL-8 was 21.64 (95% CI: 7.37 to 63.54) (Fig 4). Among all these studies, a significant heterogeneity (I2 = 77.3%) was detected. The corresponding SROC curve was plotted in Fig 5, which showed the AUC was 0.8908 with standard error of 0.0539 and the Q* value was 0.8215 with standard error of 0.0560. It also showed a moderate accuracy of IL-8 test to diagnose NS. The pooled PLR value of IL-8 test was 4.58 (95% CI: 2.44 to 8.60); whereas, pooled NLR value of IL-8 test was 0.25(95% CI: 0.13 to 0.48) (Fig 6).


Interleukin-8 for diagnosis of neonatal sepsis: a meta-analysis.

Zhou M, Cheng S, Yu J, Lu Q - PLoS ONE (2015)

The positive LR and negative LR of IL-8 test on diagnosis NS.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440704&req=5

pone.0127170.g006: The positive LR and negative LR of IL-8 test on diagnosis NS.
Mentions: The pooled Diagnostic Odds Ratio of IL-8 was 21.64 (95% CI: 7.37 to 63.54) (Fig 4). Among all these studies, a significant heterogeneity (I2 = 77.3%) was detected. The corresponding SROC curve was plotted in Fig 5, which showed the AUC was 0.8908 with standard error of 0.0539 and the Q* value was 0.8215 with standard error of 0.0560. It also showed a moderate accuracy of IL-8 test to diagnose NS. The pooled PLR value of IL-8 test was 4.58 (95% CI: 2.44 to 8.60); whereas, pooled NLR value of IL-8 test was 0.25(95% CI: 0.13 to 0.48) (Fig 6).

Bottom Line: The diagnostic threshold analysis showed that there was no threshold effect.The meta-regression analysis showed the cut-off, QUADAS and onset time have no effect on the heterogeneity.However, we should combine the results with clinical symptoms and signs, laboratory and microbial results.

View Article: PubMed Central - PubMed

Affiliation: Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

ABSTRACT

Background: Neonatal sepsis (NS) is a life-threatening disorder and an important cause of morbidity and mortality in neonates. Previous studies showed that interleukin 8 (IL-8) may effectively and rapidly diagnose NS.

Objective: We conducted the systematic review and meta-analysis to investigate the diagnostic value of the IL-8 in NS.

Methods: The literature was searched in PUBMED, EMBASE, Cochrane Library, CNKI, VIP and other Chinese Medical Databases during October 1998 to January 2014 using set search criteria. Each included study was evaluated by quality assessment of diagnostic accuracy studies tool. Two investigators independently extracted the data and study characteristics, and disagreements, if any, were resolved by consensus. Meta-disc software was used to calculate the pooled sensitivity, specificity and summary diagnostic odds ratio (SDOR), I² or Cochrane Q to test heterogeneity, and meta-regression to investigate the source of heterogeneity. Funnel plots were used to test the potential presence of publication bias. False-positive report probability (FPRP) was calculated to confirm the significance of the results.

Results: Eight studies (548 neonates) were included in this meta-analysis. The pooled sensitivity and specificity of IL-8 were 0.78 and 0.84, respectively, which had moderate accuracy in the diagnosis of NS. The pooled diagnostic odds ratio (DOR) and area under curve (AUC) was 21.64 and 0.8908 (Q*=0.8215), respectively. The diagnostic threshold analysis showed that there was no threshold effect. The meta-regression analysis showed the cut-off, QUADAS and onset time have no effect on the heterogeneity. The funnel plots showed the existence of publication bias.

Conclusion: Meta-analysis showed IL-8 had a moderate accuracy (AUC=0.8908) for the diagnosis of NS. IL-8 is a helpful biomarker for early diagnosis of NS. However, we should combine the results with clinical symptoms and signs, laboratory and microbial results.

No MeSH data available.


Related in: MedlinePlus